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Dillon, Lucy (2017) Dublin Drug Policy Summit. Drugnet Ireland , Issue 62, Summer 2017 , pp. 7-8.

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The Dublin Drug Policy Summit was held on 20 January 2017. It was organised by the Ana Liffey Drug Project and attended by national and international experts on drug policy, including policy-makers, practitioners, and academics. Among the delegates were Minister of State for Communities and the National Drugs Strategy Catherine Byrne TD and Ruth Dreifuss, chair of the Global Commission on Drug Policy (GCDP).1 The summit focused on two issues: supervised injecting facilities and the decriminalisation of possession of drugs for personal use. This article is based on the published proceedings of the event, which present a thematic analysis of the issues discussed.2,3 

Supervised injecting facilities

It is Irish Government policy to introduce a supervised injecting facility.4 The summit focused on discussing how best to operationalise the facility. The key points discussed were grouped under the broad themes of people, place, and policing. 

People

Access criteria: There was general agreement among participants that any access criteria should be as broad as possible and that any related legislation should not extend to defining which groups could access the service. The two groups noted in particular were pregnant women and those aged under 18. However, it was agreed that access should only be given to people who are already injecting drug users. Specialised protocols could be put in place for particular groups, and practitioners would have the flexibility to make decisions on a case-by-case basis to best meet the service user’s needs.

An appealing service for potential service users: Having a service that appeals to users was considered critical. A number of themes were raised on this issue. First, there was both curiosity and apprehension among potential service users about what the service would be like and how it would work. Second, a good atmosphere and a person-centred approach that builds positive relationships between staff and service users is what would truly make the service appealing. Third, the service needs to be accessible and the importance of its proximity to where people buy their drugs was noted. While NIMBYISM – Not in My Back Yard – may present challenges, evidence from other jurisdictions did not show a ‘honeypot effect’ for supervised injecting facilities, i.e. they have not drawn in more dealers and users to an area. Finally, there were issues relating to the staffing of the facility. The attitude of staff members is key; they need to be able to deal with the paradox of being healthcare professionals (in some cases), while also supervising injecting, which is an ‘inherently dangerous activity’ (p. 14), as well as always treating service users humanely. 

Place

The building: It was suggested that the building should not be overly clinical. Instead, it should be a safe place for people suited to the development of therapeutic relationships. For accessibility, it should be in the city centre. A mobile facility could be considered, as it could follow the flow of the target population.

Engaging the community: The location of the facility has attracted a lot of interest in the broader community and it was expected that NIMBYISM would be an issue. First, it was suggested that the supervised injecting facility would need to follow the practice of existing drug services in Dublin of engaging proactively with the community. Based on international experience, this would be an important element of the ongoing management of the facility. Second, communities elsewhere were reported to have been ultimately welcoming of these facilities despite initial opposition. They had a positive effect on an area, and the need to collect good baseline data to be able to evidence any such changes was noted.

Integration with other services: Supervised injecting facilities need to be embedded in the wider service landscape. First, there is a need to offer users access to other related services. This would require providers to identify and define pathways through the service and on to other services. Second, the provision of suitable ancillary services at the facility can be important, for example, access to food and showers. 

Policing

Impact on drug markets and crime levels: As these facilities are not a criminal justice intervention, it was noted that they should not be expected to impact significantly on crime, either positively or negatively. The impacts will be in terms of the service user’s health and the public amenity. However, international examples show that these facilities are not associated with increases in crime. Similarly, they do not affect any change in the drug market.

Role of policing: There was much discussion about the complexities involved in the policing of the centre and a number of key points were identified. First was that the role of law enforcement agencies should not be underestimated in the successful delivery of the service. Establishing a positive and transparent relationship between police and the facility’s management was identified as crucial. Second were the complexities involved in the approach taken to the policing of service users. Experiences in other jurisdictions highlighted these in terms of decision-making on whether to stop and search people in the vicinity of these facilities, for example. Overall, it was noted that Irish police are ‘aware of the complexities of policing in the context of social and health issues and take a very pragmatic approach to dealing with people on the street every day’ (p. 19). While there was no clear answer as to what was the best approach, there was a clear call for discretion on the part of the police and for it to be applied consistently. This would be facilitated by legislative clarity. 

Decriminalisation

The decriminalisation of the possession of small amounts of drugs for personal use is not Government policy but an issue of growing debate. The discussion at the summit in this regard fell into three broad themes: general discussion, responses, and threshold limits. 

General discussion

A number of key points were made during the general discussion on decriminalisation. First, it was important not to overstate its benefits – it was not a panacea and it alone would have little or no impact on levels of drug use. Where changes in the law have led to better outcomes for users (e.g. in Portugal), this was likely related to a broader shift in policy and investment in services, rather than a change in the law as such. Second, criminalisation causes harms. For example, it might mean users are less likely to access services, and labelling someone as a criminal can have a sustained negative effect on their life and opportunities. Third, the language used around the debate requires consideration; ‘decriminalisation needs to be framed as a health and social issue rather than a criminal one’ (p. 21). Fourth, while some stakeholders were convinced about decriminalisation, others were not and concerns remained. These included concerns about the message it might send to (particularly young) people about drug use, and the new challenges it might present for law enforcement agencies. Finally, the importance of balance in drug policy generally was noted – ‘going too far either way on a restrictive/permissive spectrum is likely to result in significant harms and be unhelpful as a policy approach attempting to minimise harm’ (p. 21). 

Responses

Some of the discussion focused on what would be the most appropriate responses if someone were found in possession of drugs where it had been decriminalised. First, it was noted that decriminalisation does not mean the absence of any consequences for being found in possession of a controlled substance. Instead, these could take the form of a civil rather than a criminal sanction. Portugal’s experience was highlighted, with a focus on the benefits of having sanctions for possession that do not come with a criminal record, stigma or the expending of a large amount of resources. There was also a call for research on what would be the most appropriate responses in the Irish context. 

Threshold limits

Threshold limits were also discussed, i.e. the amount of drugs that a person could possess before they were considered to be in possession for supply. While it was recognised that there was a need for thresholds to be established, it was also suggested that they should be carefully selected and should not be rigid. Instead, there should be flexibility to allow for the needs of the individual to be considered. By doing so, the courts could refer to the health authorities and vice versa.

 

1    The Global Commission on Drug Policy is ‘an international reference regarding the impacts of the current drug control strategy, proposing policy recommendations that protect human rights, scale-up harm reduction and promote development’. It is made up of 23 political leaders and leading thinkers from across the political spectrum. For more information, visit http://www.globalcommissionondrugs.org/

2    Ana Liffey Drug Project (2017) Dublin Drug Policy Summit. Dublin: Ana Liffey Drug Project. https://www.drugsandalcohol.ie/27186/

3    To facilitate a more open discussion, the summit followed the Chatham House Rule, whereby any reported views or comments from the session are not attributed to any particular individual or organisation. It is not suggested that all delegates agreed with or supported the statements reported in the proceedings document.

4    The Misuse of Drugs Act (Supervised Injecting Facilities) Bill 2017 was published in February 2017.

Item Type:Article
Issue Title:Issue 62, Summer 2017
Date:July 2017
Page Range:pp. 7-8
Publisher:Health Research Board
Volume:Issue 62, Summer 2017
EndNote:View
Subjects:L Social psychology and related concepts > Physical context or place > Safe spaces for drug users (injecting centre / consumption rooms)
MM-MO Crime and law > Justice system > Community anti-crime or legal assistance programme > Community policing
MM-MO Crime and law > Justice system > Law enforcement agency > Police (Garda)
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use > Drug decriminalisation or legalisation
T Demographic characteristics > Intravenous / injecting drug user
VA Geographic area > Europe > Ireland > Dublin

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